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APHA 1996 Abstract: Issues Regarding HIV Education, Counseling and
Testing by Consent to Women of Reproductive Age in Chicago
Presented at: American Public Health Association 124th Annual Meeting, November 1996
Issues Regarding HIV Education, Counseling and Testing by Consent to Women of Reproductive Age in Chicago. Afsaneh Rahimian, Ph.D., Philip Ricks, Mary Driscoll, RN, MPH, Dean Taylor, Mardge Cohen, M.D. Despite the recommendations from the Centers for Disease Control and Prevention (CDC) regarding the importance of HIV education, counseling, and testing for all women of reproductive age, especially pregnant women, a significant number of prenatal providers are not offering these services. The result of the 076 clinical trial and other more recent trials confirm the urgency of early identification of HIV positive pregnant women. Yet bulking a system that incorporates HIV education, counseling, and testing by consent and ZDV therapy as parts of a prenatal care package faces many challenges and barriers. In 1994, Health Resources Services Administration (HRSA) funded the Maternal and Child Health/HIV Integration Project to address these problems in the greater Chicago area. Following an earlier needs-assessment survey that identified the lack of training as the greatest barrier to implementing HIV education, counseling, and testing for women of reproductive age, in-depth qualitative interviews were conducted with key personnel in family planning and prenatal care sites, local and state public health officials, and other non-profit AIDS advocacy and service providers. These interviews identified other barriers both to implementing testing and counseling as well as ZDV therapy, including cost (HIV testing, follow up, and ZDV), physicians attitudes and biases toward HIV testing, denial of HIV as a major problem by suburban providers, lack, of trained staff, clients' denial/fear of seeing themselves at risk, logistics of implementation, and lack of access to care for all HIV positive women especially suburbanites.
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